7 Things to Do Before Trying to Get Pregnant: Preconception Checklist
If you are trying to get pregnant soon, there are several important steps you can take before you start trying to prepare for pregnancy and better understand your fertility.
This preconception checklist from Dr. Natalie Crawford covers ovulation tracking, semen analysis, AMH testing, prenatal vitamins, medications, genetic testing, and lifestyle changes.
IN THIS VIDEO:
00:00 Trying to Get Pregnant? Start Here
00:20 What Is Trimester Zero?
01:18 How to Track Ovulation When Trying to Conceive
02:32 Coming Off Birth Control Before Pregnancy
03:19 Why a Semen Analysis Matters
03:54 AMH Testing and Ovarian Reserve
04:27 Prenatal Vitamins Before Pregnancy
05:12 Medications and Medical Conditions Before Pregnancy
05:36 Preconception Testing and Genetic Carrier Screening
07:05 Lifestyle and Fertility
07:52 When to Get a Fertility Evaluation
08:52 Your Fertility Timeline
What Is Trimester Zero?
The three months before pregnancy can be thought of as “trimester zero.” This is an opportunity to focus on the factors that may affect egg and sperm quality before conception.
Sperm develop over approximately 72 days, which means that changes made now can affect sperm in about three months. Eggs are also more sensitive to the environment around them during the 60 to 90 days before ovulation.
If you want to optimize your chance of success, these are seven important steps to consider before trying to conceive.
1. Learn Your Cycle and Track Ovulation
Knowing when your period comes is not the same as knowing when you ovulate. If you are trying to get pregnant, it is important to understand whether you are ovulating and when ovulation occurs.
There are several ways to track ovulation, including:
Basal body temperature
Wearable devices and fertility tracking apps
Ovulation predictor kits
Urinary hormone monitoring
Cervical mucus changes
Basal body temperature rises after ovulation because progesterone increases your temperature. Urinary hormone tests look for the LH surge, which occurs shortly before ovulation. Cervical mucus can become sticky and stretchy, similar to egg whites, around the time of peak estrogen levels.
There is not one method that is best for everyone. The most useful approach is the one that works for your body and your life.
If your cycles are irregular or you cannot detect ovulation, consider getting a fertility evaluation sooner rather than simply continuing to try without more information.
2. Have Your Partner Get a Semen Analysis
Male factor can contribute to up to half of the causes of infertility. Unlike a regular menstrual cycle, ejaculation does not confirm that sperm are present or that the sperm are healthy.
A semen analysis can provide important information before a couple spends months or years trying to conceive. It may be arranged through an OB GYN, a fertility doctor, or a mail in testing option.
Testing early can help identify a possible problem and give you and your partner more information as you make decisions about pregnancy.
3. Ask About AMH and Ovarian Reserve
AMH, or anti Müllerian hormone, is a simple blood test that can provide information about ovarian health and ovarian reserve.
AMH is not a direct test of fertility. A normal AMH does not guarantee that someone can get pregnant, and an abnormal AMH does not mean that pregnancy is impossible. However, the result may help with fertility planning.
A lower AMH may raise questions about why ovarian reserve is lower and whether additional evaluation or a different timeline should be considered. It may also be a reason to discuss a full fertility evaluation or fertility treatment sooner.
Ask your doctor whether AMH testing is appropriate for you.
4. Start Taking a Prenatal Vitamin
A prenatal vitamin provides additional nutrition before and during pregnancy. One of the most important nutrients to look for is folic acid.
The recommendation discussed in this video is at least 400 micrograms of folic acid each day. Folic acid is important because the neural tube, which becomes the brain and spinal cord, begins forming very early in pregnancy.
Having appropriate folic acid stores before conception is important because this development can begin before someone knows they are pregnant.
5. Review Your Medical Conditions and Medications
The time before pregnancy is a good opportunity to review any medical conditions and medications with the healthcare professional who prescribes them.
Some medications may need to be changed before pregnancy. Making those changes ahead of time can help avoid switching medications in the middle of pregnancy.
Talk to whoever prescribes your medications to make sure they are pregnancy safe and to discuss whether anything should be switched before you begin trying to conceive.
6. Consider a Preconception Visit and Testing
A preconception visit with your OB GYN can help you review your medical history, medications, and pregnancy planning before you start trying.
Preconception testing may include:
Blood type
Rubella immunity
Varicella immunity
Vaccine review
Genetic carrier screening
Rubella and varicella are important to discuss because the vaccines are live virus vaccines and cannot be given once someone is pregnant. If you are not immune, your doctor can discuss the appropriate next steps before conception.
You may also consider genetic carrier screening for you and your partner. This testing can show whether both partners carry the same autosomal recessive genetic condition. If both people carry the same condition, you can discuss the results with a doctor or genetic counselor and consider the options that are right for you.
There is not one right or wrong decision for every person. The important thing is to have the information before making a decision.
7. Build a Fertility Focused Lifestyle
A fertility focused lifestyle is an anti inflammatory lifestyle that supports overall health before pregnancy.
This includes:
Stopping smoking
Stopping cannabis use
Stopping alcohol use
Limiting coffee to once a day
Eating more fruits, vegetables, fiber, and whole foods
Limiting processed foods
Lifting weights
Prioritizing sleep
The video recommends lifting weights three times a week and creating an environment that supports better sleep. This can include reducing distractions, keeping the room cool, using a sleep mask, and avoiding scrolling on your phone.
The goal is to reduce inflammation and create healthy habits before pregnancy.
When Should You Get a Fertility Evaluation?
You do not have to wait until you have been trying unsuccessfully to get a fertility evaluation. You can ask your OB GYN or contact a fertility clinic for testing before you begin trying.
A fertility evaluation may also be appropriate if you have been trying for one year without success. If you are 35 or older, the suggested timeline is six months.
You may want to seek an evaluation sooner if you have:
Irregular periods
Painful periods
Heavy bleeding
Difficulty with intercourse
Difficulty with erection or ejaculation
PCOS
Endometriosis
Low ovarian reserve
Another known fertility concern
Normal fertility testing does not guarantee that pregnancy will happen. The purpose of testing is to identify potential problems early so you can address them and make a more informed plan.
The Bottom Line
Before trying to get pregnant, take time to understand your cycle, track ovulation, review your health, and learn more about both partners’ fertility. A semen analysis, AMH test, prenatal vitamin, medication review, preconception visit, genetic carrier screening, and fertility focused lifestyle may all be part of the conversation.
You do not have to wait until something goes wrong to gather information. Preparing before pregnancy can help you make decisions with a clearer understanding of your fertility and your options.
Frequently Asked Questions
What Should I Do Before Trying to Get Pregnant?
Start by learning your cycle and tracking ovulation. You can also discuss a semen analysis, AMH testing, prenatal vitamins, medications, preconception testing, and lifestyle changes with your healthcare provider.
When Should I Start Taking a Prenatal Vitamin?
The video recommends having appropriate folic acid stores before conception. Look for a prenatal vitamin with at least 400 micrograms of folic acid.
Should My Partner Get a Semen Analysis Before We Start Trying?
A semen analysis can provide important information about sperm before you spend months or years trying to conceive. Male factor can contribute to up to half of the causes of infertility.
Is AMH a Test of Fertility?
AMH is not a direct test of fertility. It can provide information about ovarian health and may help with fertility planning, but a normal AMH does not guarantee fertility and an abnormal AMH does not mean pregnancy is impossible.
When Should I Get a Fertility Evaluation?
You can get a fertility evaluation before trying to conceive. If you have been trying for one year without success, an evaluation is recommended. If you are 35 or older, consider an evaluation after six months of trying, or sooner if you have known fertility concerns.